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Overview

Since the 1960s, the universal health insurance system in Japan has provided comprehensive coverage to all Japanese citizens. Associating with economic growth, Japan has achieved numerous successes in health such as control and eradication of common infectious diseases, substantial decrease of transport accident death, and most famously, achieving the world’s highest life expectancy.

However, negative population growth with low fertility rate coupled with an ageing population, shrinking economy and increasing unemployment pose critical structural challenges to Japanese health. In addition, tight control of health-care cost and a laissez-faire approach to service delivery has resulted in a mismatch between need and supply of health-care resources and reduction in accountability for care quality. Japan’s economic slowdown, high life-expectancy and growing use of expensive technologies have led to an ever-increasing rate of health-care expenditure. Consequently, good quality of care with comparably low price is no longer available.

To counteract this, the government has adopted several reforms in the past two decades in service delivery and financing: Long-term care insurance system (2000); Integrated Community Care System (2006); The Comprehensive Reform of Society Security and Tax (2010); and Regional Healthcare Vision (2014).

Moreover, young Japanese health-care leaders have already proposed Japan Vision: Health Care 2035, which encourages a paradigm shift to the new system, with a goal to build a sustainable health-care system that delivers better health outcomes through care that is responsive and equitable to each member of the society and that contributes to prosperity in Japan and the world.